medical expertise as a historical phenomenon and academic

Acta Clin Croat 2010; 49:89-97
Review
MEDICAL EXPERTISE AS A HISTORICAL PHENOMENON
AND ACADEMIC DISCIPLINE
Živko Gnjidić1 and Stella Fatović-Ferenčić2
1
University Department of Neurosurgery, Sestre milosrdnice University Hospital; 2History of Medical Sciences
Division, Department of the History and Philosophy of Sciences, Croatian Academy of Sciences and Arts,
Zagreb, Croatia
SUMMARY – Based on secondary literature, a survey of particular forms of medical expertise
over history is presented. The state-to-individual interaction in terms of personality and physical
integrity protection, health care, etc., was observed. It was only after the 16th century that the development of anatomy was found to have become a decisive argument for convincing expertise in
various trials. In Croatia, the course of medical expertise development was comparable to the close
settings in the neighboring European countries. Major advances at the legislative, educational and
professional levels took place in the second half of the 19th century. The subject of Forensic Medicine
was introduced at Royal Academy of Jurisprudence as early as 1861; the book entitled Lěčnička izvěšća (visa reperta) za praktičnu porabu lěčnikov by Ivan Dežman (1841-1873) from 1868 offered the first
systematic form of autopsy reports, whereas Kratka sudska medicina, a handbook in forensic medicine
by Niko Selak (1861-1891) from 1889 denoted the beginnings of forensic medicine literature in Croatian language. It has been noted that medical expertise approach perceives man as a social being at
the crossing of manifold impacts and influences, thus being always observed by physicians of various
specialties. During centuries, medical expertise has been formed in conjunction with advances in
medicine and science, and with the development of civil society. Medical expertise had gradually
grown into a multidisciplinary field requiring high professionalism, ethical approach, continuous
training and collaboration with various professions. This resulted in a compact and polyvalent discipline, in Croatia gradually formed as a special course in medical curriculum.
Key words: History of medicine; Forensic medicine – history; Forensic medicine – trends; Expert systems – history; Expert systems – legislation and jurisprudence; Croatia
Twentieth century was characterized by pandemics of traumatism caused by industrialization and fast
development of communications. The life accompanied by high risks, alienation, and overall commercialization entailed intensive development of insurance industry1-3. At the same time, major advances
in medicine, ever higher availability of medical serCorrespondence to: Živko Gnjidić, MD, University Department
of Neurosurgery, Sestre milosrdnice University Hospital, Vinogradska c. 29, HR-10000 Zagreb, Croatia
E-mail: zgnjidic@kbsm.hr
Received November 2, 2009, accepted January 8, 2010
Acta Clin Croat, Vol. 48, No. 3, 2009
Book Acta 1-2010.indb 89
vices to the ever greater proportion of the population,
higher patient expectations, and also increased depersonalization of the patient-healthcare professional
relationship have resulted in the ever increasing number of requests for damage repair. In the majority of
cases, these confl icts of interest are resolved by civil
lawsuits in which medical expertise has a major role4.
Medical expertise has been firmly rooted in modern
society, reflecting its development and mirroring the
perception of reciprocity, legal principles and codes,
the concept of damage and damage indemnity, etc.
Development of medical expertise reveals exchanges
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Ž. Gnjidić and Stella Fatović-Ferenčić
of interaction between the law and medicine, morality and culture, developmental processes and stepwise
society democratization. Therefore, the historical development of the field is closely associated with due
knowledge about the development of medicine, science, law, as well as of cultural features and philosophy of morality that have molded human endeavors in
different periods5-7.
During history, almost every organized social system generated some form of standardized proceedings
related to the protection of rights and/or health of the
population. From overseas cultures to Greece as the
nursery of the European culture, there were endeavors that could be considered as the earliest beginnings
of medical expertise. Yet, those early efforts should
be viewed as the origins in establishing the system of
values in the organization of life within a community
rather than establishing the institution of medical expertise in current terms.
Based on secondary literature, a survey of particular forms of medical expertise over history is presented. The state-to-individual interaction in terms of
personality and physical integrity protection, health
care, etc., was observed. The aim is to illustrate the
continuity of the formation of a field that has seen
most intensive development in our era, having gradually set its place in medical curriculum in Croatia.
Community Organization and Medical Expertise in
the Ancient Greek-Roman Culture
The Greek culture and medicine were essentially
based on the macro- and micro-cosmos relation,
tending to set standard criteria through continuous
challenging the idea of living together, moralistic
activities in the community, customs and behavioral
patterns. The social and political reality of the Greek
world relied on slave-holding that ensured living on
other’s work while also creating life privileges. It was
the time of the holistic concept of man and his health,
with the central figure of Hippocrates (460-377 B.C.),
father of medicine, and a powerful symbol of treatment and deontological principles underlying the then
medicine. Formulation of attitudes concerning the internal structure and type of government within the
polis influenced the clarification of various reasoning
and directions in political philosophy and gradual
formation of legal awareness. This can be exemplified
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Book Acta 1-2010.indb 90
Medical expertise as a historical phenomenon and academic discipline
by the attitudes of the two outstanding physicians,
Hippocrates and Plato, supporting individualistic
ethics on the one hand and statist ethics on the other
hand. Eugenics in this sense had already taken hold in
Plato’s ideas, discriminating individuals with chronic
and mental diseases and disabled persons, leaving no
room for any protection of their rights. Healthy body
was a social imperative, a sort of dignity category8.
On the other hand, the paternalistic physician-to-patient relationship put the patient in a submissive position to comply with any physician’s decision. Such an
asymmetric position could by no means support the
patient’s fi ling charge for possible indemnification.
In addition, medicine was then a theoretical science
and sources related to medical testifying at legal trials,
in particular autopsy based expertise, are not known.
Legal proceedings were exclusively a personal issue,
even in case of homicide. Public law in modern sense,
where offenders are persecuted by the state, was hardly known at the time. However, in spite of the lack
of documentation on the true medical evidence, some
parts of the orator speeches on the offenders describe
the role of evidence in the form of statement5.
Law developed into properly formed and relevant
field of human activity within the borders of the Western Roman Empire. In Roman law, specific sanctions
began to be sentenced for many unlawful offences that
are currently considered as non-material damage, the
most important of these, private penalties (poena) being the one related to intentional violation of the other’s personality (injuria). Every Roman citizen having
sustained violation of his personality including physical integrity had the right to fi le charges against the
offender and demand indemnity in money. The level of
punishment was determined according to the severity
of offence in each individual case, but there is no reliable evidence that a physician was involved in the procedure. As the public life including court proceedings
in ancient Rome took place on the Forum, forensic
medicine was named after it centuries later. In spite
of the act on the length of pregnancy (to determine
the child’s legality) as well as the well known Lex regia and Lex Cornelia and severe punishments for their
violation, little is known about medical expertise or
trials related to violation of these norms. Death penalty was inflicted for those performing artificial abortion, in particular if the woman had died. The work
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Ž. Gnjidić and Stella Fatović-Ferenčić
of physicians was submitted to strict legal regulations
and close surveillance by medical associations taking
care of due compliance with those legal regulations.
Isolated examples of expertise on the health condition
of slaves mention midwives, surveyors and other related professionals as witnesses reporting their expert
opinion to the court. These data clearly indicate that
the use of medical evidence and knowledge in terms
of medical expertise was unknown at that time. In
spite of the ambitious legislative regulations enacted
during Roman Empire, autopsy was a crucial element
that was lacking on hearing of evidence and medical
expertise, and neglected for centuries thereafter5.
The civilization breakup following the Roman Empire collapse had enormous impact on the entire European continent. The Middle Ages feudalism developed during the very tumultuous period characterized
by riot and violence. Medical expertise was replaced
by witness testimony based on forced confession and
superstition. However, the structure and methods of
the Roman law were to a considerable extent taken
over by many barbarian groups that conquered Italy
and neighboring areas. A new civilization was gradually taking power in some parts of Europe, while the
power of Islam was also expanding. Law schools that
were relatively early established in the Islamic society
defined the specific role of expertise in legal process.
Large scholarly centers were developed in the towns in
south Spain and Italy. Their disciplines included law
and medicine, where scientists of the Islamic, Jewish
and Christian origin worked together. These centers
preserved the tenets of the Greek and Roman civilization for the times to come. This in turn resulted in a
system that included witness examination, which has
persisted to the present.
Middle Ages Transformation of Legal Mentality and
Emergence of the Coroner Position
Middle Ages laid the foundations of modern Europe, from morality and legislation through institutionalization of medical and law university institutions, professionalization, development of trade and
economy, having eventually seeded the idea of united
Europe. This period entailed numerous transformations in the legal mentality and led to the reinforcement and build-up of a specific life of social community. Living in the formed towns required development,
Acta Clin Croat, Vol. 49, No. 1, 2010
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Medical expertise as a historical phenomenon and academic discipline
revision and adjustment of regulations, which resulted
in the renaissance and expansion of legislation9. In
the 8th century, Charlemagne (742-814) demanded
medical expertise to be legally introduced again (the
Capitularia codex), however, this attempt failed soon
after his death. The number of town statutes was on
an increase, developing in terms of detailed presentation of customary law. Henry II Curtmantle had
an outstanding knowledge of the law and developed
rich legal service in England. Legal practice was also
introduced in Germany, under the pretext of pacifist
movement. Current historical analyses describe 12th
century as the era of legislation, not only in terms
of Roman law revival but also by thorough elaboration of the canon law based on Gratianus’ di Bologna Decretum Gratiani. Such a transformation of legal
mentality intensified endeavors in search for a more
exact definition of relationship between members of
particular classes, professions, etc.9,10. It definitely influenced definition of various aspects within medicine
and its role in judicial system.
In England and Wales, the coroner position was
introduced in 1194, initially as a tax collector, among
others in charge of finding hidden possessions, especially in case of suicide. In such cases, the possessions belonged to the Crown. Suicide was condemned
sharply and the possessions of those dying violent
death were quite commonly confiscated. Murders of
the Normans were frequent in England after Norman Conquest. In this context, the coroner’s role was
to establish violent death, of foreigners in particular.
When murder of a Norman was established, a fine
called Murdrum was hit upon the respective area; the
English word murder has been coined from this term.
The role of coroner in verifying death by violence is
illustrated by the death of Richard Hunne from 1514,
murdered by the London bishop’s subjects by thrusting a wire through his nose into the brain and hanging him simulating suicide. The case was investigated
in detail by the coroner and the jury11.
In inland Europe fostering the influence of Roman
law, some forms of forensic activity were preserved. In
Middle Ages, generally a neighbor or a citizen familiar with the case rather than an independent person
was summoned to take role of expert witness. Local
citizens used to be summoned to take the stand to
describe the event and give their opinion about the
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Ž. Gnjidić and Stella Fatović-Ferenčić
suspects, while the jury took the role of witnesses and
decided on the guilt. The role of the jury and witnesses was more properly defined much later, however, the
jury could still act as witnesses as well, and it remained
so until the 17th century.
In Croatia, the legal codex from 1288, written in
Croatian language and containing legal regulations
for the Vinodol area, known as Vinodol Codex, brings
a series of articles that reveal the criminal law system and elaborates crimes against person, including
physical injuries, rape, defamation of character, and
an article against witches. However, the Vinodol Codex articles say nothing about the person providing
expertise of injuries sustained by the victim; it is only
stated that the cost of physician’s care after wound infl iction or fight has to be reimbursed to the injured12.
The development of medicolegal institutes is inseparable from endeavors for the protection of the
individual (the injured/patient as well as the physician/surgeon) and the community as a whole. Typical examples of individual protection were agreements
made between the physician/surgeon and patient,
where mutual obligations concerning determination
of payment, way of payment, responsibility for failure, etc., were identified. The main purpose of those
agreements was to protect the physician from prosecution in case of treatment failure. These agreements
were generally so composed to present the patient as
submitting to the physician ‘as being dead’. The surgeon handed his knife over to the patient, then the
patient handed the knife back to the surgeon, thus
the surgeon being released from responsibility for the
possible death of the patient and at the same time protected the surgeon from blood feud. Despite it, physicians and surgeons were frequently accused of having
caused disease worsening or even death due to negligence and ignorance. Therefore, guilds of surgeons
were founded in Middle Ages, followed by guilds of
midwives, for protection and accomplishment of their
rights13-15.
The statutes of Dalmatian towns offer a precious source of data on health care and medicolegal
services15,16. These documents show that physicians
in Šibenik and Dubrovnik were obliged to report to
the authorities the injuries they diagnosed. In 1272,
an act on the court procedure similar to the current
procedure was passed in Dubrovnik. The Dubrovnik
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Medical expertise as a historical phenomenon and academic discipline
Republic government appointed physicians that presented their expert opinion on the severity of physical
injuries, instruments of the crime, and causes of violent
death17. During the 15th century, judicial proceedings
were instituted on the basis of civil (private) or expert (medical) charge. The then court fi les reveal that
expertise was most commonly used for traumas due
to wound infliction, thus it was mostly performed by
surgeons. At that time, autopsy for medical expertise
had already been established in the neighboring European towns, e.g., Padua, Bologna and Venice, while
there are no data on autopsy taken for this purpose in
Dubrovnik and other Croatian towns. Some authors18
believe that among others, one of the reasons for this
was the lack of institutional basis as a proper frame for
autopsy, along with a relatively low proportion of violent deaths in our region as compared with some Italian towns, e.g., Venice. According to data on the 14th
century eighth decade, for instance, twenty physicians
performed a total of sixty autopsies in Venice19.
Foundations of the Institute of Medical Expert
The turnaround in the study of human body during the period of Renaissance generated a different attitude towards medicine, while the reform of anatomy
shook the very foundations of the Aristotle-Galen axis
of health and disease interpretation. Anatomic dissection was now put into the center of medical education, having also become the key point in modifying
the medical paradigm. At that time, Ambroise Paré
(1510-1592), a French surgery reformer, in addition
to numerous achievements and novel methods in the
field of surgery and obstetrics, included court reports
in his famous work Ouvres de M. Ambroise Paré, conseiller et premier chirurgien du Roy, published in 1575.
Besides other Paré’s contributions, mention should be
made of his precise descriptions of the signs of violent
death caused by drowning, lightning and poisoning;
he also lists indications for the assessment of virginity,
infanticide, etc.20.
Although the importance of medicine and law interaction in medical expertise was for the first time
emphasized in Justinian Code (529-533 AD), the
Constitutio Criminalis Bambergensis, elaborated by
the bishop of Bamberg in 1507, is considered as the
beginning of standardization of medicolegal institutionalization. This act codified medical expertise in all
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Ž. Gnjidić and Stella Fatović-Ferenčić
cases of violent death and served as a model for the
subsequent Constitutio Criminalis Carolina from 1532,
which confirmed the role of medical expert. Thus,
foundations for establishing the medical expert institution within governmental authorities were gradually built up, although medical expertise was still performed variedly and at different frequency in different
regions. In England, the service was performed within the frame of the above mentioned coroner institute
and was as such transferred to America, where medicolegal autopsies were recorded from the 17th century
onward5.
Establishment of Forensic Medicine as Academic
Discipline
Having considered all cases where physicians are
engaged as medical experts, Paolo Zacchia (15841659) developed a system and laid foundations of
medical expertise by his fundamental work entitled
Quaestiones medicolegales (1621-1631). Published in ten
volumes and containing chapters on the assessment of
pregnancy and child’s legality, impotence and sterility,
sexual perversions, mental illnesses, injuries, poisonings, etc., it made a great success and was considered
as a basis of the medicolegal practice until the beginning of the 19th century21.
The first lectures in forensic medicine as an elective subject were introduced in the 17th century at
German universities. The number of reports on physicians’ expertise at courts all over Europe increased in
the 17th and 18th century. At that time, first autopsies performed in order to detect the cause of death
or to verify homicide by poisoning were described. In
1752, Dr. Addington, an English physician, was the
first to use a scientific method in medical expertise to
demonstrate the cause of poisoning. Forensic medicine as a required subject was introduced in France in
1794 (Paris, Strasbourg, Montpellier), in Italy in 1801
(Pisa), and in England in 1803 (Edinburgh). In the
17th and 18th century, forensic medicine and medicolegal expertise were part of quite ill-defined regulation
that varied in its implementation. In spite of the above
mentioned advances in the field of medicolegal expertise initiated in the 17th century and continued during
the Enlightenment, true professionalization and institutionalization of this profession in modern terms
began in the 19th century, when the process of systemActa Clin Croat, Vol. 49, No. 1, 2010
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Medical expertise as a historical phenomenon and academic discipline
atic involvement of professionally competent experts
in the medicolegal practice was initiated 5,6.
Regulation of the Role and Work of Medical Experts
in Croatia
The great shift in science and medicine in the 19th
century was decisive for the development of medical
expertise. Some fifty certificates issued by Zagreb
bishop physicians on autopsy findings and severity of
injuries during the 1800-1846 period point to a defined and systematic approach according to which the
physician had to explore and record the injuries, and
only then could issue his opinion5,6. At the mid-19th
century, the payment of medical experts was officially
regulated, thus his social and professional position being more clearly defined 22.
In Zagreb, lectures in forensic medicine were much
earlier held for lawyers than for physicians. At Zagreb
Royal Academy of Jurisprudence, lectures in forensic medicine were held by Mavro Sachs (1819-1888),
a physician, from 1861. The lectures for law students
were not limited to theoretical lectures, but public
experiments in chemical toxicology and autopsy were
also performed in the scope of university education 22.
Besides Sachs, lectures in forensic medicine were also
delivered by another outstanding figure of the Croatian medicine, Antun Lobmayer (1844-1906). Upon
return from his medical study in Vienna, he was first
appointed railway prison physician in Osijek, then
professor and head of National Maternity Hospital,
and assistant professor of forensic medicine and health
legislation at School of Law in Zagreb14. At the mid19th century, coroner’s inquest was stimulated by a decree on judicial coroner’s inquest, issued by the Ministry of Interior and Justice as of January 28, 185523.
Although this decree regulated the protocol form, in
practice it was not uniformly written and was mostly
issued in German or Latin language. Therefore, the
work by Ivan Dežman (1841-1873) entitled Lěčnička
izvěšća (visa reperta) za praktičnu porabu lěčnikov, published in 1868, was beyond doubt a pioneer project
aiming at offering the physicians involved in expertise
a linguistically and structurally systematized form for
writing autopsy protocols24. The next advance in the
field was the appearance of forensic medicine hand-
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Ž. Gnjidić and Stella Fatović-Ferenčić
book in 1889, Kratka sudska medicina by Niko Selak
(1861-1891), considered the first work in forensic
medicine literature written in Croatian 25.
Development of Forensic Medicine in the Twentieth
Century
The foundation of the School of Medicine, University of Zagreb in 1917 established conditions for
the development of academic and scientific medicine,
along with development and differentiation of medical professions at the national level. Upon foundation of the School of Medicine, lectures in forensic
medicine were held by Ljudevit Jurak, Professor at the
School of Veterinary Medicine. In 1932, Dr. Eduard
Miloslavić (1884-1952) was invited by the School
of Medicine and came to Zagreb from the USA. In
1935, he established Department of Forensic Medicine and Criminalistics, School of Medicine, University of Zagreb5,6,26-28.
After World War II, considerable advances were
recorded in defining and regulation of the methods
and standards of medical evidence, with special reference to the use of all scientific methods available in
the formation of so-called ‘irrefutable evidence’ and
insisting on the role of medical expert presenting objective and reasoned opinion based on facts and evidence.
Development of forensic medicine was in part influenced by medical expertise, which has remained in
the domain of this profession to the present. Forensic
medicine is mostly focused on the forensic aspects of
expertise, solving the problems and issues regulated
by criminal law. By inherent nature, forensic medicine
makes use of medical state-of-the-art in analysis of
the type and severity of crime, thus being involved in
the state repression instruments29.
Considering the continuity of medical expertise, at
all times to the present it is observed to have exceeded
the competence of a single profession, thus having
always involved physicians of various specialties. In
the forensic medicine approach, man has been observed through the interaction of manifold influences
that determine him as a social being within a community. Democratization of the society has resulted
in ever growing awareness of protection of the rights,
personality and integrity of each individual, while the
responsibility for injuries is assessed according to the
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Book Acta 1-2010.indb 94
Medical expertise as a historical phenomenon and academic discipline
general rules of the civil law, i.e. according to the Act
on Obligative Relationship provisions30. Responsibility for injuries is considered whenever the general preconditions of this Act are met, even when the actual
type of injury is not specified in the Act. Health care
service has now become available to the majority of
the population. In addition to medical rules, ethical,
legal and economic standards regulating the complex
and finely tuned relations have been ever more important in the physician-to-patient and health care
system-to-patient relationship. Even some minor irregularities in these relations may cause major injury
in the patient31-33.
In spite of all preventive measures, the rate of
general traumatism and various types of injuries sustained within the health care system has not yet been
shown to decline. This unfavorable tendency has been
accompanied by constant increase in the number of
claims for indemnity in civil trials. A precise and
objective evaluation of non-material damage to the
person, obtained by medical expertise, is one of the
substantial instruments on establishing the civil-law
responsibility for the injury and criteria for indemnity
adjudication4,34-36.
Daily practice imposes the need of continuous development and training of medical experts in terms
of their proficiency in procedural law and other legal
proceedings, along with the need of most objective
and reliable expertise performed by different medical
specialists. Therefore, in 1997 the Croatian Medical
Association established the Croatian Society of Medical Expertise, as holder of continuous postgraduate
education of medical experts. Since the Society establishment, 30 Postgraduate Courses of Continuous Education for Medical Experts Involved in Legal
Procedures have been organized, now under the auspices of the Zagreb School of Medicine, and attended
by 563 students from different medical specialties.
In addition, Introduction in Medical Expertise has
been included as a multidisciplinary elective subject
at Zagreb University School of Medicine since 2004.
A handbook entitled Uvod u medicinsko vještačenje u
građanskim parnicama37 has been published for use at
Postgraduate Course of Continuous Education for
Medical Experts Involved in Legal Procedures and
in Introduction in Medical Expertise as a multidisciplinary elective subject at the School of Medicine.
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Ž. Gnjidić and Stella Fatović-Ferenčić
Conclusion
Over centuries, medical expertise has been formed
in conjunction with advances in science and medicine,
as well as with the development of civil society. At
the international level and in Croatia, medical expertise has gradually grown into an interdisciplinary and
multidisciplinary field that requires professional and
ethical approach, continuous training and close collaboration with different professions. Thus, medical
expertise has developed into a compact and polyvalent
discipline; in Croatia, it has also gradually turned into
a special course of medical curriculum.
Initial steps were taken at School of Medicine,
University of Zagreb, where the Introduction in Medical Expertise has been included in the undergraduate
curriculum as elective subject, while a book entitled
Introduction in Medical Expertise in Civil Lawsuit
has been printed for the elective subject at the postgraduate Continuous Education Course for Forensic
Experts in Legal Proceedings.
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Koprivnica: Dr. T. Bardek General Hospital, 1995.
26. DUGAČKI V. Eduard Miloslavić, Zmaj od Sv. Mandaljene,
svjedok istine o Katynskoj šumi. In: GETLIHER A, ed.
Znameniti članovi Družbe Braća hrvatskoga zmaja. Zagreb:
Acta et studia draconica, 1997; pp. 13-24.
27. ZEČEVIĆ D. Obnovljeni Zavod za sudsku medicinu i
kriminalistiku. In: ŠVAJGER A, ed. Medicinski fakultet u
Zagrebu 1917.-1997. Zagreb: Zagreb University School of
Medicine, 1997; pp. 73-6.
28. FATOVIĆFERENČIĆ S, DUGAČKI V. Ljudevit Jurak
(1881-1945) and Eduard Milošević (1884-1952). Founders of
Croatian pathological and forensic medicine and experts at
investigations of mass graves at Katyn and Vinnitsa during
World War II. In: DEBONS D, et al., eds. Katy et la Suisse.
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29. Kazneni zakon. Narodne novine 110/97.
30. Zakon o obveznim odnosima. Narodne novine 35/05, 41/08.
34. BOŠKOVIĆ Z. Medicina i pravo. Zagreb: Pergamena,
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31. NIKŠIĆ S. Basic features of medical liability. Lijec Vjesn
2008;130:282-8.
35. CRNIĆ I. Neimovinska šteta. Zagreb: Organizator, 2006;
pp. 39-40.
32. PAUKOVIĆ H. Legal aspects of medical expert testimony
and non-economic damage in civil liability of physician. Lijec
Vjesn 2008;130:288-93.
36. JANKOVIĆ S, ČIZMIĆ J. Liječnička pogreška – medicinski i pravni aspekti. Split: Split University School of Medicine,
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33. IVEKOVIĆ R. Professional and ethical medical expert quality. Lijec Vjesn 2008;130:305-6.
37. GNJIDIĆ Ž, BILIĆ R. Uvod u medicinsko vještačenje u
građanskim parnicama. Zagreb: Medicinska naklada, 2008.
Sažetak
ULOGA MEDICINSKOG VJEŠTAČENJA U ZAŠTITI PRAVA GRAĐANA TIJEKOM POVIJESTI
Ž. Gnjidić i S. Fatović-Ferenčić
Na temelju sekundarne literature u ovom radu se iznosi pregled pojedinih oblika medicinskog vještačenja tijekom povijesti. Prati se interakcija države i pojedinca u smislu zaštite osobnosti, tjelesnog integriteta, zaštite zdravlja i sl. Uočeno
je da je razvoj anatomije postao ključan argument za uvjerljivu provedbu vještačenja u različitim parnicama istom nakon
16. stoljeća. Na području Hrvatske razvoj medicinskog vještačenja tekao je slično kao i u bliskim sredinama susjednih
europskih zemalja. Tijekom druge polovine 19. stoljeća uočavaju se pomaci na zakonodavnoj, obrazovnoj i stručnoj razini. Sudska medicina kao predmet počinje se predavati na zagrebačkoj Kraljevskoj pravoslovnoj akademiji već od 1861.
godine; djelo Ivana Dežmana (1841.-1873.) Lěčnička izvěšća (visa reperta) za praktičnu porabu lěčnikov iz 1868. ponudilo
je prvi usustavljeni obrazac za pisanje obdukcijskih protokola, dok je priručnik sudske medicine Kratka sudska medicina
Nike Selaka (1861.-1891.) iz 1889. obilježio početke sudskomedicinske literature pisane hrvatskim jezikom. Istaknuto je
da je medicinsko vještačenje u okviru svog pristupa promatralo čovjeka kao društveno biće na razmeđi svekolikih utjecaja i
njime su se oduvijek bavili liječnici različitih kompetencija. Medicinsko se vještačenje tijekom stoljeća oblikovalo u sprezi s
napretkom medicine i znanosti, te izgradnjom civilnoga društva. Ono je postupno izrastalo u multidisciplinarno područje
koje zahtijeva stručnost, etičnost u pristupu, kontinuirano usavršavanje i suradnju s različitim strukama. Samim time ovo
se ustrojilo u kompaktnu i polivalentnu disciplinu te se i na području Hrvatske postupno oblikuje i kao zaseban predmet
u okviru medicinskog kurikuluma.
Ključne riječi: Povijest medicine; Medicinsko vještačenje – povijest; Medicinsko vještačenje – trendovi; Ekspertni sustavi –
povijest; Ekspertni sustavi – zakonodavstvo i pravosuđe
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Fig. 1. Panoramic view of medieval Šibenik with a note on rewarding physicians. (Painting received by the courtesy of Asst.
Prof. Damir Kovač, PhD, from his personal collection).
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